HB1151

Regular Session

Relating to neglect of a child and the grounds for termination of the parent-child relationship and possession of a child by the Department of Family and Protective Services.

LowStandard timeline

Low Cost

Effective:2025-05-28

Enforcing Agencies

Department of Family and Protective Services (DFPS) • Texas Family Courts

Compliance Analysis

Key implementation requirements and action items for compliance with this legislation

Implementation Timeline

Effective Date: May 28, 2025 (Immediate effect due to supermajority vote).
Compliance Deadline: Immediate. Any report filed today based on the prohibited grounds is legally invalid and exposes the reporter to potential administrative or civil liability.
Agency Rulemaking: While no formal rulemaking deadline is set, DFPS must update internal casework handbooks immediately. Expect a "regulatory gray zone" regarding the definition of "recognized alternative health care" until the first test cases move through the family courts.

Immediate Action Plan

1. Issue a "Stop-Report" Directive: Immediately notify all mandatory reporters that refusal of psychotropic meds or seeking second opinions are no longer valid grounds for a DFPS report.
2. Update Compliance Manuals: Remove "doctor shopping" and "medication non-compliance" from your list of automatic neglect red flags, specifically regarding mental health.
3. Audit Pending Cases: If you have open internal investigations or pending reports based on these grounds, close them immediately.
4. Revise AMA Protocols: Ensure discharge planning for parents refusing psychotropics focuses on education rather than threats of CPS involvement.

Operational Changes Required

Contracts

Consent to Treat & Admission Agreements: Review "Against Medical Advice" (AMA) clauses. A parent transferring a child to a holistic provider or refusing psychiatric medication can no longer be contractually defined as "neglect" or automatically trigger a DFPS referral.
Vendor/Staffing Agreements: Third-party social workers and case managers must have their scopes of work amended to reflect these statutory exclusions to ensure they do not file non-compliant reports on your behalf.

Hiring/Training

Mandatory Reporter Training: Immediate "Stand Down" training is required for all clinical staff, school counselors, and teachers. They must be explicitly instructed that refusing ADHD medication, anti-depressants, or other psychotropics is not a reportable offense.
Triage Protocols: Front-line staff must be trained to distinguish between "refusal of psychotropics" (protected) and "refusal of life-sustaining treatment" (e.g., insulin or antibiotics), which remains reportable under the "substantial risk of death" exception.

Reporting & Record-Keeping

Incident Reports: If a report is made despite a parent's refusal of care, the documentation must now explicitly cite the statutory exception: "substantial risk of death, disfigurement, or bodily injury" or "observable and material impairment."
Clinical Documentation: Vague chart notes such as "non-compliant parent" are now liability risks. Documentation must be specific regarding the *physical* consequence of the non-compliance to justify any DFPS involvement.

Fees & Costs

Budget Impact: Low.
Potential Costs: Potential increase in legal defense costs if your organization is accused of harassing parents for exercising these new statutory rights.

Strategic Ambiguities & Considerations

"Recognized Alternative Health Care": The statute protects parents choosing "recognized" alternative treatments but does not define the accrediting body for such recognition. Until DFPS clarifies, businesses should assume a broad interpretation to avoid litigation.
"Observable and Material Impairment": This is the primary enforcement loophole. The law does not define the threshold for "material." DFPS may attempt to argue that a child's inability to focus in school (due to lack of medication) constitutes "material impairment."
*Guidance:* Adopt a conservative threshold. Do not report unless the impairment is physical or severely developmental.

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Information presented is for general knowledge only and is provided without warranty, express or implied. Consult qualified government affairs professionals and legal counsel before making compliance decisions.

Legislative Timeline

This bill's path through the Texas Legislature

TopicsFamily Family--child Protection Family--parent & Child Mental Health & Substance Abuse Medicine & Prescription Drugs Family & Protective Services, Department of

Official Analysis

View HRO Analysis View All Bill Documents

BILL ANALYSIS

H.B. 1151

By: Hull

Human Services

Committee Report (Unamended)

BACKGROUND AND PURPOSE

The author has informed the committee that parents in Texas have faced Child Protective Services investigations for refusing to consent to psychotropic medication or psychiatric treatments for their children. Current state law does not specifically address the circumstances under which such refusal does not constitute neglect for purposes of a court's termination of the parent-child relationship or the state taking possession of a child, nor does the law address a parent's decision to pursue alternative health care treatment or therapy for such purposes. If state law were to reflect that a parent's refusal of such medication or treatments or their decision to pursue alternative treatment or therapy for their child does not constitute neglect, parents may feel further empowered to make decisions in the best interest of their child. H.B. 1151 seeks to ensure that parents can safely make necessary decisions for their children without the fear of unwarranted state interference by providing clarity on the circumstances in which the state may intervene to protect the child.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

H.B. 1151 amends the Family Code to establish that, for purposes of a court's order to terminate the parent-child relationship, evidence of any of the following actions does not constitute clear and convincing evidence unless the action presents a substantial risk of death, disfigurement, or bodily injury to the child or results in an observable and material impairment to the growth, development, or functioning of the child:

·the parent refused to administer or consent to the administration of a psychotropic medication to the child or to consent to any other psychiatric or psychological treatment of the child; or

·the parent chose a recognized alternative health care treatment or therapy for the child that could be considered as new, emerging, or nonstandard.

H.B. 1151 prohibits the Department of Family and Protective Services (DFPS) from taking possession of the child based on evidence of any such action by a parent unless the action presents a substantial risk of death, disfigurement, or bodily injury to the child or results in an observable and material impairment to the growth, development, or functioning of the child. Moreover, the bill establishes that the definition of "neglect" under current law relating to investigations of reports of child abuse or neglect does not include such an action by a person responsible for a child's care, custody, or welfare unless the action presents such a risk or results in such an impairment.

H.B. 1151 applies only to a suit filed by DFPS on or after the bill's effective date. A suit filed by DFPS before that date is governed by the law in effect on the date the suit was filed, and the former law is continued in effect for that purpose.

EFFECTIVE DATE

September 1, 2025.

House Authors

Rep. Lacey HullRepublican · Primary Author

Coauthors (6)

Senate Sponsors

Sen. Royce WestDemocrat · Primary Sponsor

Cosponsors (1)

Cesar Blanco (D)

Bill Text(with markup)

H.B. No. 1151

View bill text in multiple formats on Texas Legislature website

Fiscal NoteView Original

	AN ACT
	relating to neglect of a child and the grounds for termination of
	the parent-child relationship and possession of a child by the
	Department of Family and Protective Services.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1. Section 161.001(c), Family Code, is amended to
	read as follows:
	(c) Evidence of one or more of the following does not
	constitute clear and convincing evidence sufficient for a court to
	make a finding under Subsection (b) and order termination of the
	parent-child relationship:
	(1) the parent homeschooled the child;
	(2) the parent is economically disadvantaged;
	(3) the parent has been charged with a nonviolent
	misdemeanor offense other than:
	(A) an offense under Title 5, Penal Code;
	(B) an offense under Title 6, Penal Code; or
	(C) an offense that involves family violence, as
	defined by Section 71.004 of this code;
	(4) the parent provided or administered low-THC
	cannabis to a child for whom the low-THC cannabis was prescribed
	under Chapter 169, Occupations Code;
	(5) the parent declined immunization for the child for
	reasons of conscience, including a religious belief;
	(6) the parent sought an opinion from more than one
	medical provider relating to the child's medical care, transferred
	the child's medical care to a new medical provider, or transferred
	the child to another health care facility; [or]
	(7) the parent allowed the child to engage in
	independent activities that are appropriate and typical for the
	child's level of maturity, physical condition, developmental
	abilities, or culture;
	(8) the parent refused to administer or consent to the
	administration of a psychotropic medication to the child, or to
	consent to any other psychiatric or psychological treatment of the
	child, unless the refusal:
	(A) presents a substantial risk of death,
	disfigurement, or bodily injury to the child; or
	(B) results in an observable and material
	impairment to the growth, development, or functioning of the child;
	or
	(9) the parent chose a recognized alternative health
	care treatment or therapy for the child that could be considered as
	new, emerging, or nonstandard, unless the treatment or therapy:
	(A) presents a substantial risk of death,
	disfigurement, or bodily injury to the child; or
	(B) results in an observable and material
	impairment to the growth, development, or functioning of the child.
	SECTION 2. Section 261.001(4), Family Code, is amended to
	read as follows:
	(4) "Neglect" means an act or failure to act by a
	person responsible for a child's care, custody, or welfare
	evidencing the person's blatant disregard for the consequences of
	the act or failure to act that results in harm to the child or that
	creates an immediate danger to the child's physical health or
	safety and:
	(A) includes:
	(i) the leaving of a child in a situation
	where the child would be exposed to an immediate danger of physical
	or mental harm, without arranging for necessary care for the child,
	and the demonstration of an intent not to return by a parent,
	guardian, or managing or possessory conservator of the child;
	(ii) the following acts or omissions by a
	person:
	(a) placing a child in or failing to
	remove a child from a situation that a reasonable person would
	realize requires judgment or actions beyond the child's level of
	maturity, physical condition, or mental abilities and that results
	in bodily injury or an immediate danger of harm to the child;
	(b) failing to seek, obtain, or follow
	through with medical care for a child, with the failure resulting in
	or presenting an immediate danger of death, disfigurement, or
	bodily injury or with the failure resulting in an observable and
	material impairment to the growth, development, or functioning of
	the child;
	(c) the failure to provide a child
	with food, clothing, or shelter necessary to sustain the life or
	health of the child, excluding failure caused primarily by
	financial inability unless relief services had been offered and
	refused;
	(d) placing a child in or failing to
	remove the child from a situation in which the child would be
	exposed to an immediate danger of sexual conduct harmful to the
	child; or
	(e) placing a child in or failing to
	remove the child from a situation in which the child would be
	exposed to acts or omissions that constitute abuse under
	Subdivision (1)(E), (F), (G), (H), or (K) committed against another
	child;
	(iii) the failure by the person responsible
	for a child's care, custody, or welfare to permit the child to
	return to the child's home without arranging for the necessary care
	for the child after the child has been absent from the home for any
	reason, including having been in residential placement or having
	run away; or
	(iv) a negligent act or omission by an
	employee, volunteer, or other individual working under the auspices
	of a facility or program, including failure to comply with an
	individual treatment plan, plan of care, or individualized service
	plan, that causes or may cause substantial emotional harm or
	physical injury to, or the death of, a child served by the facility
	or program as further described by rule or policy; and
	(B) does not include:
	(i) the refusal by a person responsible for
	a child's care, custody, or welfare to permit the child to remain in
	or return to the child's home resulting in the placement of the
	child in the conservatorship of the department if:
	(a) the child has a severe emotional
	disturbance;
	(b) the person's refusal is based
	solely on the person's inability to obtain mental health services
	necessary to protect the safety and well-being of the child; and
	(c) the person has exhausted all
	reasonable means available to the person to obtain the mental
	health services described by Sub-subparagraph (b);
	(ii) allowing the child to engage in
	independent activities that are appropriate and typical for the
	child's level of maturity, physical condition, developmental
	abilities, or culture; [or]
	(iii) a decision by a person responsible
	for a child's care, custody, or welfare to:
	(a) obtain an opinion from more than
	one medical provider relating to the child's medical care;
	(b) transfer the child's medical care
	to a new medical provider; or
	(c) transfer the child to another
	health care facility;
	(iv) the refusal by a person responsible
	for a child's care, custody, or welfare to administer or consent to
	the administration of a psychotropic medication to the child, or to
	consent to any other psychiatric or psychological treatment of the
	child, unless the refusal:
	(a) presents a substantial risk of
	death, disfigurement, or bodily injury to the child; or
	(b) results in an observable and
	material impairment to the growth, development, or functioning of
	the child; or
	(v) choosing a recognized alternative
	health care treatment or therapy for the child that could be
	considered as new, emerging, or nonstandard, unless the treatment
	or therapy:
	(a) presents a substantial risk of
	death, disfigurement, or bodily injury to the child; or
	(b) results in an observable and
	material impairment to the growth, development, or functioning of
	the child.
	SECTION 3. Section 262.116(a), Family Code, is amended to
	read as follows:
	(a) The Department of Family and Protective Services may not
	take possession of a child under this subchapter based on evidence
	that the parent:
	(1) homeschooled the child;
	(2) is economically disadvantaged;
	(3) has been charged with a nonviolent misdemeanor
	offense other than:
	(A) an offense under Title 5, Penal Code;
	(B) an offense under Title 6, Penal Code; or
	(C) an offense that involves family violence, as
	defined by Section 71.004 of this code;
	(4) provided or administered low-THC cannabis to a
	child for whom the low-THC cannabis was prescribed under Chapter
	169, Occupations Code;
	(5) declined immunization for the child for reasons of
	conscience, including a religious belief;
	(6) sought an opinion from more than one medical
	provider relating to the child's medical care, transferred the
	child's medical care to a new medical provider, or transferred the
	child to another health care facility;
	(7) allowed the child to engage in independent
	activities that are appropriate and typical for the child's level
	of maturity, physical condition, developmental abilities, or
	culture; [or]
	(8) tested positive for marihuana, unless the
	department has evidence that the parent's use of marihuana has
	caused significant impairment to the child's physical or mental
	health or emotional development;
	(9) refused to administer or consent to the
	administration of a psychotropic medication to the child, or to
	consent to any other psychiatric or psychological treatment of the
	child, unless the refusal:
	(A) presents a substantial risk of death,
	disfigurement, or bodily injury to the child; or
	(B) results in an observable and material
	impairment to the growth, development, or functioning of the child;
	or
	(10) chose a recognized alternative health care
	treatment or therapy for the child that could be considered as new,
	emerging, or nonstandard, unless the treatment or therapy:
	(A) presents a substantial risk of death,
	disfigurement, or bodily injury to the child; or
	(B) results in an observable and material
	impairment to the growth, development, or functioning of the child.
	SECTION 4. The changes in law made by this Act apply only to
	a suit filed by the Department of Family and Protective Services on
	or after the effective date of this Act. A suit filed by the
	department before that date is governed by the law in effect on the
	date the suit was filed, and the former law is continued in effect
	for that purpose.
	SECTION 5. This Act takes effect September 1, 2025.

LEGISLATIVE BUDGET BOARD
Austin, Texas

FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION


March 15, 2025

TO:	Honorable Lacey Hull, Chair, House Committee on Human Services

FROM:	Jerry McGinty, Director, Legislative Budget Board

IN RE:	HB1151 by Hull (Relating to neglect of a child and the grounds for termination of the parent-child relationship and possession of a child by the Department of Family and Protective Services.), As Introduced

No significant fiscal implication to the State is anticipated.

The bill would prohibit the termination of the parent-children relationship or have the Department of Family and Protective Services take possession of a child, based on the evidence that the parent refused to administer or consent to the administration of a psychotropic medication to the child, or to consent to any other psychiatric or psychological treatment of the child and/or if the parent chose a recognized alternative health care treatment or therapy for the child that could be considered new, emerging, or nonstandard.

It is assumed any costs to the Department of Family and Protective Services and the Office of Court Administration could be absorbed within existing appropriations.

Local Government Impact

No fiscal implication to units of local government is anticipated.

Source Agencies:

212 Office of Court Administration, Texas Judicial Council, 530 Family and Protective Services, Department of

LBB Staff:

JMc, NPe, ER, AN

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Frequently Asked Questions

Common questions about HB1151

What does Texas HB1151 do?

HB1151 immediately restricts the Department of Family and Protective Services (DFPS) from removing children or terminating parental rights based solely on a parent's refusal of psychotropic medication, choice of alternative therapies, or decision to seek a second medical opinion. This legislation effectively redefines "medical neglect," requiring healthcare providers, mental health facilities, and educational institutions to immediately revise mandatory reporting protocols to avoid liability for improper reporting or interference with parental rights. Implementation Timeline Effective Date: May 28, 2025 (Immediate effect due to supermajority vote).

Who authored HB1151?

HB1151 was authored by Texas Representative Lacey Hull during the Regular Session.

When was HB1151 signed into law?

HB1151 was signed into law by Governor Greg Abbott on May 28, 2025.

Which agencies enforce HB1151?

HB1151 is enforced by Department of Family and Protective Services (DFPS) and Texas Family Courts.

How urgent is compliance with HB1151?

The compliance urgency for HB1151 is rated as "low". Businesses and organizations should review the requirements and timeline to ensure timely compliance.

What is the cost impact of HB1151?

The cost impact of HB1151 is estimated as "low". This may vary based on industry and implementation requirements.

What topics does HB1151 address?

HB1151 addresses topics including family, family--child protection, family--parent & child, mental health & substance abuse and medicine & prescription drugs.

Legislative data provided by LegiScanLast updated: November 25, 2025

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